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Comparison of Outcomes Between Additional Esophagectomy After Noncurative Endoscopic Resection and Upfront Esophagectomy for T1N0 Esophageal Squamous Cell Carcinoma

  • Original Article – Thoracic Oncology
  • Published:
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Abstract

Background

Esophagectomy with lymph node dissection is a choice of additional treatment after noncurative endoscopic resection (ER) of T1N0 esophageal squamous cell carcinoma (ESCC). The efficacy and safety of esophagectomy in this situation remain unclear when compared with upfront esophagectomy.

Methods

We investigated the short- and long-term outcomes of 321 patients with clinical T1N0M0 ESCC who underwent curative esophagectomy, and compared the status of lymph node metastasis, surgical results, and the prognosis between the ER and non-ER groups.

Results

The ER group consisted of 57 patients (17.8%), while the non-ER group consisted of 264 patients (82.2%). The incidence of lymph node metastasis was not significantly different between the ER (24.6%) and non-ER groups (30.7%), and there was no significant difference in surgical outcomes between the groups. The distribution of metastatic lymph nodes was very similar between the groups. However, 13 of 14 patients (93%) with lymph node metastasis in the ER group and 63 of 82 patients (77%) with lymph node metastasis in the non-ER group had pN1 disease, while the remaining 18 patients (23%) with lymph node metastasis in the non-ER group had pN2 or N3 disease. Overall and relapse-free survival rates were significantly better in the ER group than in the non-ER group (p < 0.05 and p < 0.01, respectively). To date, no patients in the ER group experienced disease recurrence.

Conclusions

Additional esophagectomy is a safe and effective treatment modality for patients after noncurative ER.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

    Suguru Maruyama MD, PhD, Akihiko Okamura MD, PhD, Yu Imamura MD, PhD, Jun Kanamori MD, PhD, Yasukazu Kanie MD, Keita Takahashi MD, PhD, Daisuke Fujiwara MD, PhD & Masayuki Watanabe MD, PhD, FACS

Authors
  1. Suguru Maruyama MD, PhD
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  2. Akihiko Okamura MD, PhD
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  3. Yu Imamura MD, PhD
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  4. Jun Kanamori MD, PhD
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  5. Yasukazu Kanie MD
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  6. Keita Takahashi MD, PhD
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  7. Daisuke Fujiwara MD, PhD
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  8. Masayuki Watanabe MD, PhD, FACS
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Corresponding author

Correspondence to Masayuki Watanabe MD, PhD, FACS.

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Disclosure

Suguru Maruyama, Akihiko Okamura, Yu Imamura, Jun Kanamori, Yasukazu Kanie, Keita Takahashi, Daisuke Fujiwara, and Masayuki Watanabe declare they have no conflicts of interest.

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Maruyama, S., Okamura, A., Imamura, Y. et al. Comparison of Outcomes Between Additional Esophagectomy After Noncurative Endoscopic Resection and Upfront Esophagectomy for T1N0 Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 28, 4859–4866 (2021). https://doi.org/10.1245/s10434-020-09498-z

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  • DOI: https://doi.org/10.1245/s10434-020-09498-z

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